癌症病人末期病情告知與心理情緒之相關性研究

A Survey of Terminal Cancer Patients' Truth Telling and Their Emotional Disturbance

高綺吟(Chi-Yin Kao) ； 胡文郁(Wen-Yu Hu) ； 邱泰源(Tai-Yuan Chiu)

《安寧療護雜誌》 17卷3期 (2012/11) Pp. 288-299

https://doi.org/10.6537/TJHPC.2012.17(3).4

摘要

研究目的：本研究旨在瞭解癌末病人的末期病情告知與心理情緒間的相關性。材料與方法：本研究採問卷調查法針對北部某醫學中心照會安寧共同照護病人進行立意取樣，共收案100位。問卷內容包括病人基本資料、病情瞭解程度、對疾病的不確定感以及醫院焦慮憂鬱量表（中文版），以SPSS19.0進行皮爾森積差相關及單因子變異數分析。結果：1.僅54%的癌末病人知道末期病情；39%很確定且強烈感受到不確定感。2.在焦慮憂鬱的情緒狀態方面，平均得分分別為5.41分及8.84分，顯示癌末病人有「憂鬱傾向」。3.年齡越輕組別及教育程度越高組別，對末期病情瞭解度顯著高於年紀越大者及及教育程度越低者。4.病情瞭解度越高者，不確定感顯著低於病情瞭解度低者。5.末期的病情瞭解度與不確定感與呈負相關。不確定感與焦慮程度與憂鬱程度呈正相關。結論：告知癌末病人病情，應可降低病人對疾病的不確定感，也有助於緩解焦慮和憂鬱程度。故及時照會安寧照護，以及加強醫護人員對末情病情告知的溝通訓練是重要的；建議臨床上可以使用醫院焦慮憂鬱量表，做為癌末病人焦慮憂鬱的快篩工具，以適時早期介入安寧緩和醫療。

關鍵字

癌末 ； 病情告知 ； 不確定感 ； 焦慮 ； 憂鬱

並列摘要

Purpose: Terminal cancer patients' truth telling and their emotional disturbance are two critical issues in clinical practice. Therefore, the study aimed to explore the association between terminal cancer patients' truth telling and their emotional disturbance. Material and Method: A questionnaire survey was used for data collection, including the understanding of the disease prognosis, uncertainty, and Hospital Anxiety and Depression Scale. Terminal cancer patients referred to the hospice-palliative care team were approached in a medical center in Taipei. Result: Only 54% of participants understood their terminal illness very well, whereas 39% of participants had strongly feeling of uncertainty. In terms of the Hospital Anxiety and Depression Scale, results indicated that terminal cancer patients had mild depression. ANOVA analysis showed terminal cancer patients with older age and lower education level had less understanding of terminal prognosis. Pearson's Correlation analysis indicated the understanding of the disease prognosis and uncertainty was negatively correlated; uncertainty and anxiety was positively correlated; anxiety and depression was positively correlated. Conclusion: Truth telling could reduce patients' uncertainty and relieve their anxiety and depression state. As a result, early hospice referral and health professionals' communication training about truth telling are needed. In regard with terminal cancer patients' depression, we recommend that the Hospital Anxiety and Depression Scale could be used to assess patients' anxiety and depression state in clinical practice. This could help health professionals identify the depressed patients and then refer to the psychiatrist in order to assist the patients' emotional disturbance on time.

並列關鍵字

Terminal cancer ； truth telling ； anxiety ； depression